Types of Edema

Edema is the accumulation of abnormal levels of fluid in the circulatory system and the tissues between the body’s cells (interstitial tissue). This condition often causes tissue underneath the skin to swell, and is common when lymphatic blockage occurs.
Swelling occurs in the blood vessels when an excessive increase in the volume of plasma fluid causes the vessels to dilate.

This excess fluid gets trapped in the body’s tissue in a greater capacity than the lymphatic system can eliminate.

Generally, edema is physically unnoticeable until the interstitial fluid volume is approximately 30% above normal (normal fluid volume is 10%).

Many American’s suffer from edema without knowing what it is, and what causes it. Edema is also referred to as oedema, which was formally labeled dropsy or hydropsy.

Symptoms of Edema

Swelling of the Skin

Localized or peripheral: swelling is in one specific area. Mainly in one of the legs or arms.

Generalized: swelling is in particular regions of the body. Such as in the extremities, a portion or all of the face, abdomen, and the feet.

Organ-specific: swelling in a particular organ such as the brain (cerebral edema), the lungs (pulmonary edema) or the eye’s (periorbital edema).

Pitting Edema: a severe case of edema which exists if skin retains a dimple after being pressed for 10 to 20 seconds.

The skin may feel tight and stretched. Edema causes the skin to feel tight as a result of being stretched beyond its normal boundaries. In some cases, skin may either feel warm to the touch, or quite cool if there is a blockage in local circulation.

Additional Symptoms to Look For

You may also experience puffiness of the ankles. Boggy ankles are one of the most common signs of peripheral edema; which is characterized by generalized swelling in the extremities.

In addition to ankle swelling, you may also experience swelling of the face or eyes. This can cause the face to become red and swollen. Swelling of the eyes can occur in the cornea of the eye due to glaucoma, conjunctivitis, keratitis, or surgery. Periorbital edema causes puffiness around the eyes, and is most noticeable immediately after waking. Other issues to watch out for are:

Weight gain: due to increased fluid retention, and lack of elimination.

Risk Factors for Edema

Congestive heart failure – blood accumulation in the legs, ankles, or feet due to the hearts inability to pump efficiently.

Cirrhosis – scarring of the liver that imbalances the secretion of hormones and chemicals regulating fluid levels in the body.

Kidney disease – cause fluid and sodium retention in the legs and around the eyes.

Nephrotic syndrome – kidney damage causing low protein levels in the blood to result in an over accumulation of fluid.

Chronic venous insufficiency (CVI) – weakening of the veins and values in the legs, which causes them to lack the proper pumping abilities needed to push blood back to the heart.

Deep vein thrombosis – a blood clot which forms in a vein, mainly in the thigh or lower leg.

Lymphedema – the improper draining of lymph nodes and vessels due to genetic predisposition, or a medical condition such as cancer or an infection.

Tests and Diagnosis

In order to treat edema a doctor has to diagnose what is causing it. However, in cases showing signs of systemic edema (caused by a malfunction of one or more of the systems in the body) or pitting edema, it is wise not to wait to seek the advice of a medical practitioner.
The initial set of test done by a medical professional is a preliminary evaluation. First, a medical history profile is completed. Then, the practitioner performs a physical assessment, comparing patient’s arms and legs for symmetrical edema and other areas of the body for dependent edema. Last, the medical professional palpates the area affected by taking peripheral pulses, by notating areas of the body that are cold to the touch, and by performing a complete cardiac and respiratory assessment.

If edema is confirmed additional test are recommended, correlating to the area of the body in which the edema occurs.

Testing for Localized Edema

Localized Edema can be determined during a patient consultation, which includes health history questionnaires, and physical assessments carried out by a medical professional. Once localized edema is suspected the following test may be done to diagnose the exact cause:

Impedance phlebography is a noninvasive test that uses electrical monitoring to measure blood flow in veins of the leg. Information from this test helps a doctor to detect deep vein thrombosis (blood clots or thrombophlebitis).

Chest X-ray (CXR) study and ECG are done to detect edema in the arms and legs.

Liver function test are done if cirrhosis is suspected.

Urinalysis and sediment evaluations are done if renal causes of edema are expected.

Organ Specific Edema Test

Organ Specific Edema test vary depending on the organ affected. However, general testing procedures still apply which include.

Complete blood count (CBC)

Urinalysis

Chest films

Electrocardiogram (ECG)

Biochemical screening which include albumin, total protein, liver function tests, total cholesterol, and thyroid function tests

Testing for Pitting Edema

Press and hold the skin for 10-20 seconds. If the dimple impression remains when released then pitting edema may exists. If pitting edema exists for more than 3 months, low serum protein levels may be an underlying factor.

Prevention Tips

At home treatments often times recommended by doctors include:

Walk regularly when traveling by car, train, boat or plane

Wear support stockings or compression bandaging

Do regular exercise

Decreasing salt intake

If overweight, loss weight

Raise legs when sleeping & several times daily

Do not stand or sit for long periods at a time

Limit the use of alcohol, sugar, caffeine, and dairy products.

Treatment Options

Before determining a treatment plan for edema, a doctor must first determine the underline cause for the swelling, and determine if it is localized to a specific area of the body, or if it is generalized in different regions of the body.

In cases which edema is found to be present, the initial recommendation is to lower sodium intake in foods consumed; or to prescribe diuretics. Bed rest and elevation of the swollen area is also recommended. And, in some situations, elastic stockings are advised as well.

In more severe cases of edema (such as edema associated with heart failure), doctors may prescribe other drugs along with diuretics in order to regulate the circulatory system.

Pharmaceutical Drugs

Pharmaceutical drugs such as antiangiogenesis drugs are sometimes prescribed to help control blood vessel growth. Some antiangiogenesis drugs as well as other prescriptions for edema are as follows:

Aldactazide

Aldactone

Aqua-Ban

Aqua-Ban with Pamabrom

Aquatensen

Aquazide H

Bumex

Demadex

Diamox

Diamox Sequels

Diuril

Diuril Sodium

Dyazide

Dyrenium

Edecrin

Enduron

Esidrix

HydroDIURIL

Lasix

Lozol

Maxzide

Maxzide-25

Microzide

Midamor

Mykrox

Naturetin

Renese

Saluron

Sodium Edecrin

Thalitone

Zaroxolyn

Surgery

Surgery is usually the final option if medications prescribed are ineffective. Edema should never be treated until the underline cause has been properly diagnosed and addressed. Although, edema is sometimes a result of surgery, there are surgical procedures done to treat the edema itself.

Thompsons Procedure: Is a surgical procedure done to build an alternative route or bypass for the lymph system.

Herbal Remedies

SinEcch™: an oral homeopathic preparation used for more than 10 years, by thousands of surgeons, as an adjuvant treatment for post-surgery edema and ecchymosis.

Dandelion: is a diuretic herb that is rich in potassium. However, the diuretic action can also eliminate potassium from the system, so it is good to consume foods and vitamins high in potassium in addition to taking dandelion.

Alternative Health Care Remedies

Acupuncture: helps to determine the cause of edema and in some cases it helps to reduce the inflammation.

Massage Therapy: by a qualified therapist. The pressure must be light to moderate, and movements must flow in the direction of the heart. Massage is a contraindication for systemic and pitting edema, but it is highly recommended for less severe edema.

Ayurveda: oils are massaged into the skin to reduce localized swelling in specific areas of the body.

Oxygen Therapy: administering oxygen as a medical treatment is good to help assist the body with efficient cell metabolism, and normal physiological functioning through tissue oxygenation. It is very effective in cases where pulmonary edema is present.

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13 Comments

Can I ever get rid of the brown color in my ankles? I have edema in the ankles, and I am a Caucasian person, but my ankles are brown, due to the edema. Also, my ankles are VERY sensitive to the touch. Is this common with edema?

My father has leg edema and it’s all the way up to his knees — He is itching and would like to know an easy way and cheap way to stop the itching and the swelling! He also has a aortic blockage it’s size is 5 and they won’t do surgery till it gets to 6 so far it’s not growing so he just want’s some relief! Please help!

I have been diagnosed with chronic venous insufficiency (CVI),but I’m having trouble trying to get back the normal look & feel of the skin after the edema comes down for awhile. I’ve tried many different rich lotions & skin creams, but the skin continues to feel & look like a tanned leather hide that flakes & peels & forms callus spots on my feet & legs, my trunk & facial skin seems less noticeable for the after-effects of swelling ~ mainly patchy areas of flakey dry skin & in some areas of my neck & face I’ll break out in a mild Rosacea-like patch. Can I get some tips on treating these resulting skin problems from my CVI? Thank you.

manual lymph drainage by a trained physical or occupational therapist can reduce the edema but if the legs are brown stained that will lighten but not go away as that is blood cells that have leaked out into the tissues.

how about edema in just the right arm, started as a bulbous mass below the elbow, a few days later bruised like patches then showed up on the under side of the arm, range of motion was restricted through 2nd day and then returned to normal, on week later the bulbous mass is still there but vastly reduced

I have put on 15 kilo in three months since I narrowly escaped dialysis after AKI. I’ve had a scan today and they said not to worry, the fluid will eventually go when the kidneys stabilize?

I’ve had bloods, ecg etc and everything shows within normal ranges however it is all localised to my stomach, lower back and bottom and I’m struggling to breathe. Get breathless very quickly which I never had before the renal failure.

My kidneys are currently back up to 59% from just 6% three months ago but I feel so uncomfortable and have had to buy new clothes, two sizes larger.

Any suggestions?

I was advised to drink 6.5 litres when discharged and now over a month at 2 litres per day.

I was 42 kilo when they failed, 42.7 the day of discharge and the day after I rocketed to 52 kilo.